The long-term surgical outcomes of lateral rectus advancement in consecutive esotropia

To evaluate the long-term surgical efficacy of lateral rectus advancement (LRadv) in patients with consecutive esotropia (CET).

The medical records of 30 patients who developed CET after bilateral lateral rectus (BLR) recession for exotropia (XT) between 2012 and 2020 were reviewed. The characteristics of patients during their XT surgery were summarized. Among them, 15 patients who underwent LRadv as CET treatment with at least a 1-year follow-up were included to evaluate the long-term efficacy of this surgical approach. The main outcomes were the pre- and post-operative angle of deviation after LRadv. Surgical success was defined as the postoperative deviation within 10 prism diopters (PD), and reoperation was not needed. All data were expressed as median and interquartile ranges.

The median follow-up was 34 months after LRadv surgery. The median postoperative deviation ranged from 28 to 1 PD at 1 year (P < 0.05) and to 5 PD at the final follow-up (P < 0.05). The deviation at each follow-up time showed no statistically significant difference (P > 0.05). The final surgical success was reduced compared to 1 day and 1 year postoperatively (60% VS 100% and 66.7%, respectively). Undercorrection and overcorrection both occurred at the final follow-up.

Although the immediate surgical outcome of LRadv was satisfactory, the success rate reduced with time, which suggests long-term observation is necessary to detect and timely provide appropriate interventions for overcorrection or undercorrection.